呼吸用コルチコステロイドの使用と,喘息の患者における骨密度
C A Wong1, L J Walsh, C J Smith
1Division of Respiratory Medicine, City Hospital, Nottingham, UK. czwong@middlemore.co.nz
Lancet (London, England)
|May 3, 2000
まとめ
吸入用コルチコステロイドの長期使用は,喘息患者の骨のミネラル密度の低下と関連しています. 累積投与量の高さは,骨密度が低いことと相関しており,特に腰椎と股関節の骨密度が低い.
科学分野:
- 肺内医学 肺内医学 肺内医学
- エンドクリノロジー エンドクリノロジー
- 骨代謝についてです.
背景:
- 吸入用コルチコステロイド (ICS) は,喘息管理に広く使用されています.
- ICSの全身吸収は,骨の健康に潜在的に悪影響を及ぼす可能性について懸念を喚起しています.
- 骨のミネラル密度 (BMD) への累積的なICS用量の影響は,広範囲で長期にわたる使用のために明確にする必要があります.
研究 の 目的:
- 累積的な吸入型コルチコステロイド被曝と骨のミネラル密度との間における用量反応関係を調査する.
- 喘息の成人における重要な骨格部位におけるICS用量とBMDとの関連性を評価する.
主な方法:
- 喘息を患っている20〜40歳の196人の成人 (119人の女性) を対象とした研究.
- 患者の病歴と医療記録に基づいて,累積的なICS用量の評価.
- 骨のミネラル密度の測定 腰椎および近親股関節における骨のミネラル密度の測定 回分析を用いて.
主要な成果:
- 累積的なICS用量と腰椎,股関節頸部,ワードの三角形,トロッカントールのBMDとの間に有意な負の関連が観察されました.
- 累積的なICS用量の倍増は,腰椎BMDの0.16SDの減少に対応しました.
- これらの関連性は,年齢,性別,およびその他の潜在的な混同要因を調整した後も依然として有意であった.
結論:
- この研究は,喘息患者の累積的な吸入コルチコステロイド用量と骨のミネラル密度との間の負の関係を示す証拠を提供します.
- 研究結果は,長期のICS使用が骨の健康に悪影響を及ぼし,モニタリングが必要であることを示唆しています.
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